Breast Augmentation: A Cross-Sectional Survey of UK and Irish Aesthetic Surgeons.

Background: Breast augmentation surgery is the most frequently performed aesthetic surgical procedure within the United Kingdom year on year. However, many variations exist among surgeons regarding various aspects of implant usage and technique. Objectives: The aim of this study was to evaluate current trends and practices in breast augmentation, within the United Kingdom and correlate them to evidence-based literature. Methods: An electronic survey of 41 questions was sent to 201 surgeons performing breast augmentation within the United Kingdom and Republic of Ireland. The survey inquired about the surgeons themselves, their practice, implant choice, surgical technique, post-op care, revision surgery, and impact of breast implant-associated anaplastic large cell lymphoma among several other questions. Results: There were a total of 166 respondents, with 146 completing the survey fully, equaling a response rate of approximately 73%. Overall, there were specific trends in certain aspects such as type of practice, number of augmentations performed per surgeon per year, preferred implant manufacturer, and implant characteristics. That said, there has been a change in other aspects such as implant texture with an increase in the use of smooth implants. The United Kingdom and Ireland concur with certain internationally dominant practice preferences, including the use of inframammary incisions and post-op bra use. Conclusions: This survey suggests that many aspects of breast augmentation surgery in the United Kingdom are approaching standardization. There are, however, some variations in practice and controversies remaining as expected. It is our belief that further standardizing this very common aesthetic surgical procedure according to evidence-based guidelines will help to improve outcomes for patients.

Aesthetic Surgery Practice Resumption in the United Kingdom During the COVID-19 Pandemic.

BACKGROUND: The global COVID-19 pandemic has significantly impacted all aspects of healthcare, including the delivery of elective aesthetic surgery practice. A national, prospective data collection was carried out of the first aesthetic plastic surgery procedures performed during the COVID-19 pandemic in the United Kingdom. OBJECTIVES: The aim of this study was to explore the challenges aesthetic practice is facing and to identify if any problems or complications arose from carrying out aesthetic procedures during the COVID-19 pandemic. METHODS: Over a 6-week period from June 15 to August 2, 2020, data were collected by means of a proforma for aesthetic plastic surgery cases. All patients had outcomes recorded for an audit period of 14 days postsurgery. RESULTS: The results demonstrated that none of the 371 patients audited who underwent aesthetic surgical procedures developed any symptoms of COVID-19-related illness and none required treatment for any subsequent respiratory illness. CONCLUSIONS: No COVID-19-related cases or complications were found in a cohort of patients who underwent elective aesthetic procedures under strict screening and infection control protocols in the early resumption of elective service.

Impact of COVID-19 on Aesthetic Plastic Surgery Practice in the United Kingdom.

BACKGROUND: The COVID-19 pandemic has transformed the delivery of medical and surgical services globally. Subsequently, all elective and aesthetic procedures have been cancelled or deferred in accordance with government-mandated quarantine measures. The Cosmetic Surgery Governance Forum (CSGF) is a network of aesthetic plastic surgery consultants which has enabled a sharing of expertise during challenging times. We conducted a cross-sectional survey to assess the impact of the COVID-19 pandemic on aesthetic plastic surgeons and their practice in the UK. METHODS: On 15 June 2020, 131 respondents from the CSGF and wider aesthetic plastic surgeons in the UK were invited to respond to an online survey. An anonymised questionnaire was created using SmartSurveyTM and distributed at the end of the quarantine period. Questions regarding their current scope of practice, willingness to recommence face-to-face consultations, financial loss and psychological impact were asked. RESULTS: A total of 101 Consultant Plastic surgeons (76%) completed the questionnaire. If strict protocols and adequate personal protective equipment were available, 50-55% of respondents would consider offering non-surgical treatments as soon as the private clinic was open. Furthermore, 51% would consider procedures under general anaesthetic, whilst 89% of respondents would offer local anaesthetic only in the initial phase. Moreover, 66% reported experiencing a psychological impact and 100% of respondents reported a significant financial impact. CONCLUSIONS: This survey aims to give an account of the current state (May-July 2020) of aesthetic plastic surgery in the UK. There is ongoing uncertainty and deliberation regarding the timing and organisational changes required for aesthetic practice to restart.

COVID-19 Reducing the Risks: Telemedicine is the New Norm for Surgical Consultations and Communications.

INTRODUCTION: COVID-19, a worldwide pandemic, has enforced a national lockdown in the UK which produced a paradigm shift about the way medical practitioners would perform consultations and communication with their patients. Senior authors realised that in lockdown there was only one option to see a patient: virtual consultation via telecommunication technologies. This paper will discuss the current benefits and considerations of Telemedicine, particularly in plastic surgery, to decipher the next route of action to further validate its use for future implementation. METHOD: A detailed literature review was carried out comparing papers from 1992 to 2020. A survey of 122 consultant plastic surgeons found an encouraging result as 70% positively embraced the suggestion of Telemedicine in their current practice. DISCUSSION: Telemedicine produced equal or improved patient satisfaction. Its utilisation reduced cost for patient, clinic and consultant. With accessibility to a large percentage of the population, Telemedicine enables infection control and adherence to social distancing during COVID-19. Considerations include dependability on internet access, legal aspects, cyber security and General Data Protection Regulation (GDPR), the inability to perform palpation or physical inspection and psychological impacts on the patient. CONCLUSION: In modern times, Telemedicine has become more accessible and COVID-19 has made it more applicable than ever before. More in-depth research is needed for validation of this technique within plastic surgery. While maintaining quality of care and a vital role in social distancing, there is a strong need for standardisation of Telemedicine processes, platforms, encryption and data storage. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .